Management of Outbreaks of Acute Respiratory Illness in Care Homes Out of Season and In Season Other areas: Where the home feels that their resident needs a clinical review, or the resident feels they need a clinical review, then it is the home’s responsibility to seek this from the resident’s GP practice, out of hours service or emergency service as appropriate. Respiratory illness outbreak suspected: Two or more cases with a new onset of respiratory symptoms arising within the same 48-hour period OR three or more cases arising within the same 72-hour period HPT to carry out the following actions: Advise Commisceo of the results of the swabs taken. Request Commisceo to supply and deliver medication for the treatment of confirmed flu positive residents and prophylaxis for exposed residents. Care Home to carry out the following actions: Supply the patient information to Commisceo immediately as previously instructed via the letter and template supplied. Ongoing care of the patient will be passed to the residents GP. Care Home to notify HPT Commisceo to carry out the following actions: Assess the dose of antiviral medication required for those residents confirmed by HPT. This will be undertaken remotely by Commisceo’s Clinician employed by the service provider. Assessment of each exposed resident for antiviral medication must take into account renal function (according to the SPC which can be found at www.medicines.org) and where necessary the dose must be adjusted accordingly. Where an exposed resident’s renal function is unknown, the service provider should refer to the CCG guidance. Use TTA packs provided by Ipswich Hospital. The Commisceo Clinician will write the name of the resident, their date of birth and any adjustment to dose on the medication label. Attend the care home and ensure that antiviral medication is provided to the home within 24 hours of being notified by HPT that the outbreak is confirmed. Complete a ‘record of supply’ (or refusal) form for each resident and return to the relevant GP practice via secure email (nhs.net). Commisceo to carry out the following actions: Arrange the timely and secure transport by courier of specimens to the regional microbiological laboratory (currently Addenbrookes Hospital). (Through CitySprint). Advise the HPT that specimens have been delivered. Key Contacts: HPT to carry out the following actions: Obtain basic epidemiology data Advise the care home on infection control. Undertake a risk assessment If Flu likely, to contact Commisceo Review actions throughout outbreak East of England Health Protection Team Thetford Community Healthy Living Centre Croxton Road Thetford IP24 1JD Telephone: 0300 303 8537 Secure Fax: 0300 303 8541 Generic email: EastofEnglandHPT@phe.gov.uk Secure email: PHE.EoEHPT@nhs.net Commisceo to carry out the following actions: Within 24 hours, Provider will take swabs from up to five symptomatic residents as advised by the HPT and complete lab request form on the template supplied by the HPT. Those with the most recent onset of symptoms will be priorities from viral swabs. Provide a letter and template to the care home requesting resident details (name, NHS number date of birth, registered GP practice and any known allergies). Care Home to carry out the following actions: Ensure the resident's GP and any other visiting health professionals are informed of the suspected outbreak. Instigate control procedures (under HPT advice) Commisceo Primary Care Solutions Jo Harvey (Service Manager) Mobile: 07885 697002 E-mail: commisceo.pcs@nhs.net Key - Responsibilities Primary Care GP Flu Outbreak Service Provider - Commisceo Health Protection Team (HPT) Care Home HPT to carry out the following actions: Advise Commisceo to carry out swabs in relevant care home Care Home to complete the template supplied by Commisceo confirming details of all residents in the care home and hold until positive results are received.